WordNet

an insertion into a calendar (同)intercalation
occlusion of a blood vessel by an embolus (a loose clot or air bubble or other particle)
of or related to the amnion or characterized by developing an amnion; "amniotic membrane" (同)amnionic, amnic

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塞栓(そくせん)症(血管に塞栓が詰まること)

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1. 羊水塞栓症候群 amniotic fluid embolism syndrome
2. 空気塞栓症 air embolism
3. 羊水量調節の生理学 physiology of amniotic fluid volume regulation
4. 羊水量の評価 assessment of amniotic fluid volume
5. 妊娠中および周産期における急性呼吸不全 acute respiratory failure during pregnancy and the peripartum period

English Journal

Decrease in bispectral index prior to cardiovascular collapse during Caesarean sections.

Kim JY, Kim KW, Cho CS, Kim JH, Lee SI, Kim KT, Park JS, Kim JW, Choe WJ.Author information Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Gyeonggi-do, Korea.AbstractWe report a case of significant reduction in bispectral index (BIS) associated with suspected amniotic fluid embolism (AFE) that occurred prior to change in haemodynamic variables. The patient was a 29-year-old nulliparous, who was admitted for Caesarean section under general anaesthesia in the 33rd week of pregnancy. After the baby was born, the BIS value suddenly decreased to 0, with suppression ratio of 100. One minute later, saturation decreased abruptly to 85%, end-tidal carbon dioxide (EtCO2) decreased to 5 mmHg, peak inspiratory pressure increased to 35 cm H2O, and non-invasive blood pressure (BP) failed to obtain a reading. After administration of vasoactive drugs, the systolic BP was maintained at 100 mmHg or higher, the BIS value rose to 10-20, and the EtCO2 increased to 24-33 mmHg. In this case, the BIS monitoring may provide an earlier warning of impending cardiovascular collapse in the case of AFE.
Acta anaesthesiologica Scandinavica.Acta Anaesthesiol Scand.2014 Jan;58(1):123-6. doi: 10.1111/aas.12203. Epub 2013 Sep 30.
We report a case of significant reduction in bispectral index (BIS) associated with suspected amniotic fluid embolism (AFE) that occurred prior to change in haemodynamic variables. The patient was a 29-year-old nulliparous, who was admitted for Caesarean section under general anaesthesia in the 33rd
PMID 24112235

Predictor of mortality in patients with amniotic fluid embolism.

Oi H, Naruse K, Koike N, Tsunemi T, Shigetomi H, Kanayama N, Kobayashi H.Author information Department of Obstetrics and Gynecology, Nara Medical University, Kashihara City, Japan.AbstractAIM: The purpose of this study was to evaluate the possibility of establishing predictors of mortality in women with amniotic fluid embolism.
The journal of obstetrics and gynaecology research.J Obstet Gynaecol Res.2013 Dec 10. doi: 10.1111/jog.12278. [Epub ahead of print]
AIM: The purpose of this study was to evaluate the possibility of establishing predictors of mortality in women with amniotic fluid embolism.METHODS: Our previous report identified eight factors associated with amniotic fluid embolism (AFE) fatality: dyspnea, cardiac arrest, loss of consciousness, s
PMID 24320844

Surgical treatment of late-onset amniotic fluid pulmonary embolism.

Yao J, Shao GG, Song W, Yang RG, Yin DX, Zhang LM, Liu YP.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.J Obstet Gynaecol.2013 Dec 2. [Epub ahead of print]
PMID 24295051

Japanese Journal

症例報告帝王切開術後に発症し,摘出子宮で子宮型羊水塞栓症と診断し得た1例

産婦人科の進歩 70(1), 24-30, 2018-02
NAID 40021465189

帝王切開術後に発症し,摘出子宮で子宮型羊水塞栓症と診断し得た1例

産婦人科の進歩 70(1), 24-30, 2018
NAID 130006588880

招待講演羊水塞栓症 : その病態と新しい治療戦略 (公益社団法人日本麻酔科学会第64回学術集会講演特集号)

麻酔 = The Japanese journal of anesthesiology : 日本麻酔科学会準機関誌 66(増刊), S138-147, 2017-11
NAID 40021389486

「羊水塞栓症」

　　[★]

英: amniotic embolism, amniotic fluid embolism
ラ: embolia liquolis amnii
関: 産科ショック。肺塞栓症

概念

妊婦の破水後、特に分娩開始後に、羊水成分が母体内に流入して引きおこされる急性呼吸循環不全および播種性血管内凝固症候群(DIC)を呈する重篤な病態である。
発症頻度は6-8万分娩に1例であるが、母体の死亡率は60-80%と著しく高い。
歴史的には1941年SteinerとLushbauchの報告が最初とされている(PMID 3514978 https://pubmed.ncbi.nlm.nih.gov/3514978/)。
病態生理は明らかではないころが多い。
診断が難しく、死亡率が高いために医療過誤を疑われることが多い。

病態生理

羊水成分・胎児成分(胎児扁平上皮、ムチン、胎便など)が母体の静脈に入り、肺血管に塞栓を生じる。急性肺循環不全や急性右心不全、また羊水成分によりDICを起こし、性器出血にて死亡に至る。
病態としては肺血管閉塞→肺高血圧→呼吸循環不全、播種性血管内凝固、SIRSの流れで起こる。
羊水成分の血液内の流入は、卵膜破綻した後に、子宮筋層断裂部や子宮内腔に露出する欠陥破綻部から起こるとされている
胎児成分による物理的な閉塞、ないし血管攣縮性物質による肺血管攣縮により肺血管抵抗が上昇して肺高血圧を来たし、左室の機能低下、低酸素血症を来す
羊水中の組織因子やプロテアーゼなどの血管内への流入により血管内血液凝固が引きおこされ、血管内皮障害を来すとされる。